scholarly journals TCT-258 Clinical significance of peri-procedural myocardial infarction following percutaneous coronary intervention for multi-vessel coronary artery disease

2016 ◽  
Vol 68 (18) ◽  
pp. B105
Author(s):  
Min Soo Cho ◽  
Do-yoon Kang ◽  
Ungjeong Do ◽  
Jung Ae Hong ◽  
Osung Kwon ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Clinical Significance ◽  
Coronary Intervention ◽  
Vessel Coronary Artery Disease ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Vessel Coronary Artery

scholarly journals Role of Drug-coated Balloons in Small-vessel Coronary Artery Disease

2019 ◽  
Vol 13 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Michael Megaly ◽  
Marwan Saad ◽  
Emmanouil S Brilakis
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Small Vessel ◽  
Vessel Coronary Artery Disease ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
Artery Disease ◽  
Vessel Coronary Artery

Percutaneous coronary intervention of small-vessel coronary artery disease (SVD) remains challenging due to difficulties with device delivery and high restenosis rate, even with the use of newer-generation drug-eluting stents. Drug-coated balloons represent an attractive emerging percutaneous coronary intervention option in patients with SVD. Potential advantages of drug-coated balloons in SVD include enhanced deliverability because of their small profile, avoidance of foreign-body implantation, and shorter duration of dual antiplatelet therapy.

scholarly journals Cost-effectiveness analysis of percutaneous coronary intervention for single-vessel coronary artery disease: an economic evaluation of the ORBITA trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044054
Author(s):  
Victoria McCreanor ◽  
Alexandra Nowbar ◽  
Christopher Rajkumar ◽  
Adrian G Barnett ◽  
Darrel Francis ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cost Effectiveness ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Single Vessel ◽  
Vessel Coronary Artery Disease ◽  
Effectiveness Analysis ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Vessel Coronary Artery

ObjectiveTo evaluate the cost-effectiveness of percutaneous coronary intervention (PCI) compared with placebo in patients with single-vessel coronary artery disease and angina despite anti-anginal therapy.DesignA cost-effectiveness analysis comparing PCI with placebo. A Markov model was used to measure incremental cost-effectiveness, in cost per quality-adjusted life-years (QALYs) gained, over 12 months. Health utility weights were estimated using responses to the EuroQol 5-level questionnaire, from the Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina trial and UK preference weights. Costs of procedures and follow-up consultations were derived from Healthcare Resource Group reference costs and drug costs from the National Health Service (NHS) drug tariff. Probabilistic sensitivity analysis was undertaken to test the robustness of results to parameter uncertainty. Scenario analyses were performed to test the effect on results of reduced pharmaceutical costs in patients undergoing PCI, and the effect of patients crossing over from placebo to PCI due to refractory angina within 12 months.SettingFive UK NHS hospitals.Participants200 adult patients with stable angina and angiographically severe single-vessel coronary artery disease on anti-anginal therapy.InterventionsAt recruitment, patients received 6 weeks of optimisation of medical therapy for angina after which they were randomised to PCI or a placebo procedure.Outcome measuresIncremental cost-effectiveness ratio (ICER) expressed as cost (in £) per QALY gained for PCI compared with placebo.ResultsThe estimated ICER is £90 218/QALY gained when using PCI compared with placebo in patients receiving medical treatment for angina due to single-vessel coronary artery disease. Results were robust under sensitivity analyses.ConclusionsThe ICER for PCI compared with placebo, in patients with single-vessel coronary artery disease and angina on anti-anginal medication, exceeds the threshold of £30 000 used by the National Institute of Health and Care Excellence when undertaking health technology assessment for the NHS context.Trial registration: The ORBITA study is registered with ClinicalTrials.gov, number NCT02062593.

Abstract 15071: Effect of Percutaneous Coronary Intervention on Death and Myocardial Infarction in Patients Withstable Coronary Artery Disease and Inducible Ischemia

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Qais Radaideh ◽  
Mohammed Osman ◽  
Babikir Kheiri ◽  
Ahmad Al-Abdouh ◽  
mahmoud Barbarawi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Stress Testing ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Artery Disease ◽  
Severe Ischemia

Introduction: There has been a continuous debate about the survival benefit of percutaneous coronary intervention (PCI) for the management of patients with stable coronary artery disease (CAD) and moderate to severe ischemia. To address this, we performed a meta-analysis of RCTs comparing PCI plus MT vs. MT alone in stable CAD patients to evaluate endpoints of all-cause mortality, cardiovascular (CV) mortality, and MI in a larger cohort of patients with objective evidence of myocardial ischemia. Methods: An electronic database search was conducted for RCTs that compared PCI on top of MT versus MT alone. A random effects model was used to calculate relative risk (RR) and 95% confidence intervals (CIs). Results: A total of 7 RCTs with 10,043 patients with a mean age of 62.54 ± 1.56 years and a median follow up of 3.9 years were identified. Among patients with (CAD) and moderate to severe ischemia by stress testing, PCI didn’t show any benefit for the primary outcome of all-cause mortality compared to MT(RR = 0.85; 95% CI 0.646-1.12; p= 0.639). There was also no benefit in cardiovascular (CV) death (RR = 0.88 ; 95% CI 0.71-1.09; p =0.18) or myocardial infarction (MI) (RR = 0.271 ; 95% CI 0.782-1.087; P =0.327) in the PCI group as compared to MT. Conclusions: Among patients with (CAD) and evidence of moderate to severe ischemia by stress testing, PCI on top of MT appears to add no mortality benefit as compared to with MT alone.

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